Transcription

1 Information for you Published in October 2014 (next review date: 2017) Healthy eating and vitamin supplements in pregnancy Who is this information for? This information is for you if you want to know more about eating healthily in pregnancy. It also gives you advice about using vitamin supplements before you get pregnant and during pregnancy. Healthy eating Keeping healthy when you are having a baby depends on both the amount and the type of food you eat before you become pregnant and during your pregnancy. Simply being a correct weight for your height does not necessarily mean that you are eating healthily. Some foods are best avoided if you are planning to become pregnant or if you are already pregnant, as they may contain substances that could affect your unborn baby s development. To eat healthily, you should aim to do the following. Base your meals on starchy foods such as potatoes, bread, rice and pasta, choosing wholegrain if possible. These foods are satisfying without containing too many calories. Eat at least five portions of different fruit and vegetables every day rather than foods that are higher in fat and calories. Potatoes do not count towards your five-a-day target, and a portion of pure fruit juice only counts as one of your five-a-day, no matter how much you drink. Eat a low-fat diet and don t increase the number of calories you eat. Eat as little fried food as possible and avoid drinks that are high in added sugars, and other foods such as sweets, cakes and biscuits that have a high fat or sugar content. Instead, eat fibre-rich foods such as oats, beans, lentils, grains and seeds, as well as wholegrain bread, brown rice and wholemeal pasta. Eat some protein every day; choose lean meat, and try to eat two portions of fish a week. Lentils, beans and tofu are also a good source of protein. 1

2 Eat dairy foods for calcium but choose low-fat varieties such as skimmed milk or low-fat yogurt. Always eat breakfast. Watch the portion size of your meals and snacks and note how often you eat. Do not eat for two. Limit your caffeine intake to 200 milligrams (mg) per day, for example two mugs of instant coffee. Be aware that other drinks such as tea and energy drinks also contain caffeine. Most women do not need any extra calories during the first six months of pregnancy. It is only in the last 12 weeks that they need to eat a little more, and then only an extra 200 calories a day, which is roughly the same as two slices of bread. What is a healthy weight? You can find out your healthy weight from your BMI (body mass index). This is a measure of your weight in relation to your height. Your healthcare team can work it out for you. A healthy BMI is above 18.5 but below 25. Being overweight carries risks for you and your baby (see the RCOG patient information Why your weight matters during pregnancy and after birth: information for you, which is available at: org.uk/womens-health/clinical-guidance/why-your-weight-matters-during-pregnancy-and-after-birth). The more overweight you are, the greater the risks. Being underweight increases the risk of your baby not growing as well as he or she should. Is it safe for me to diet while I am pregnant? Trying to lose weight by dieting during pregnancy is not recommended as it may harm the health of your unborn baby. If you are concerned about your weight, your midwife can advise you and may refer you to a dietician. Is it safe to eat fish while I am pregnant? In general, eating fish is a healthy option during pregnancy, but the current advice from the Department of Health is to eat no more than two portions of oily fish, such as mackerel or salmon, a week. This is because too much of a substance found in oily fish (mercury) can be harmful to an unborn baby s development. Also, pregnant women should not eat more than two fresh tuna steaks or four medium-sized cans of tuna a week, and should avoid eating shark, swordfish or marlin. I have been told not to eat liver while I am pregnant. Why? Liver can contain high levels of vitamin A, which in high doses can harm the development of an unborn baby s nervous system. It is rare for women in developed countries like the UK to be deficient in vitamin A so you should avoid eating foods such as liver and liver products like pâté. Is it safe to eat peanuts while I am pregnant or breastfeeding? You can eat peanuts or foods containing peanuts (such as peanut butter) while pregnant or breastfeeding. Eating peanuts does not appear to affect your baby s chances of developing a peanut allergy. Don t eat them if you re allergic to them. How can I reduce the risk of infection from food? You can pick up some infections, such as listeria, salmonella or toxoplasmosis, from contaminated food. These can harm your unborn baby. 2

3 To reduce your risk of getting listeriosis: drink only pasteurised or UHT milk avoid eating ripened soft cheese such as Camembert, Brie or blue-veined cheese; however, hard cheese varieties such as Cheddar, cottage cheese and processed cheese are safe avoid eating pâté avoid eating undercooked food; make sure that ready-prepared meals are cooked as per instructions, paying particular attention to making sure that they are piping hot when reheating. To reduce your risk of getting salmonella: avoid eating raw or partially cooked eggs or food that may contain them, such as some types of mayonnaise or mousses; check the packaging of the food to see what is in it. avoid eating raw or partially cooked meat, especially poultry and shellfish. To reduce your risk of getting toxoplasmosis: always wash your hands before and after handling food wash all fruit and vegetables, including ready-prepared salads cook raw meats and ready-prepared chilled meats thoroughly wear gloves and wash your hands thoroughly after gardening or handling soil avoid contact with cat faeces (in cat litter or in soil) or, if you must handle it, wear rubber gloves. Do I need extra vitamins (vitamin supplements) when I am pregnant? Vitamins are needed for growth and development. There are 13 important vitamins: vitamins A, C, D, E and K and the vitamin B series. Apart from vitamin D, which we get from sunlight, most vitamins come from our diet. In the UK, it is quite common for people to be low in vitamin D and folic acid (vitamin B 9 ). These vitamins are important in pregnancy and you can boost your levels by taking a vitamin supplement. Supplements of other vitamins are not usually advised since they may actually be harmful in pregnancy. The various vitamins and whether they are recommended in pregnancy are detailed below. Vitamins that are recommended Folic acid Folic acid is one of the B vitamins and helps to reduce the risk of your baby having spina bifida. Taking extra folic acid may also reduce the risk of heart or limb defects and some childhood brain tumours. The recommended daily dose is 400 micrograms (µg). Ideally, you should start taking extra folic acid before you conceive and continue to take it until you reach your 13th week of pregnancy. If you did not take folic acid before you became pregnant, start taking it as soon as you realise you are expecting a baby. Some women take a higher dose of folic acid. Why? If your risk of having a baby with spina bifida is higher than normal, you will be advised to take a daily dose of 5 milligrams (mg) of folic acid. This is higher than usual and it will need to be prescribed by a doctor. You may be advised to take an increased dose if: you have had a previous pregnancy affected by spina bifida you or your partner have spina bifida you are taking certain medications for epilepsy you have coeliac disease or diabetes 3

4 your BMI is 30 or more you have sickle-cell anaemia or thalassaemia; the higher dose of folic acid will also help to prevent and treat anaemia if you are in this situation. Vitamin D All pregnant women are advised to take a daily dose of 10 micrograms (µg) of vitamin D when pregnant and breastfeeding. This is because it is common in the UK for people to have low levels of vitamin D. Taking supplements can improve your baby s growth during his or her first year of life, and can reduce their risk of developing rickets. You are at particular risk of having low levels of vitamin D if: your family origin is South Asian, African, Caribbean or Middle Eastern your BMI is 30 or more you stay indoors a lot you usually cover your skin when you go outdoors or usually use sun-protection cream your diet is low in vitamin D-rich foods such as eggs, meat, vitamin D-fortified margarine or breakfast cereal. If you are in one of these situations, you may be may be advised to take a higher daily dose of vitamin D. When may I need extra vitamin K? Vitamin K is needed for our blood to clot properly. Newborn babies have low levels of vitamin K, which puts them at risk of bleeding. To prevent this, you will be offered vitamin K for your baby after birth. You do not need to take vitamin K supplements yourself during pregnancy unless it is thought that your baby is at particular risk of bleeding. This could be because you are taking certain medicines for epilepsy or if you have liver disease. When may I need extra vitamin C? Although routine supplements of vitamin C are not specifically recommended when you are pregnant, this vitamin helps iron to be absorbed. This may be of benefit during pregnancy, at a time when women are at risk of becoming anaemic. Vitamins that are not recommended There are many multivitamin tablets for use in pregnancy that contain a small amount of lots of vitamins. These are safe to take, but avoid taking large doses of the following vitamins unless a doctor prescribes them for a particular reason. Vitamin A Too much vitamin A can harm the development of your unborn baby s nervous system. During pregnancy, avoid any supplements that contain more than 700 micrograms (µg) of vitamin A and don t eat foods such as liver, liver products (pâté) or fish liver oils that may contain this vitamin in high levels. Vitamin E There is currently no evidence to recommend additional vitamin E during pregnancy. Vitamin B supplements (other than folic acid) You do not need any other vitamin B supplements in pregnancy. Sometimes, pyridoxine (vitamin B 6 ) is prescribed to help you feel less sick early in your pregnancy although it will not stop you from being sick. 4

5 What about extra iron? Most women do not need to take extra iron during pregnancy. Taking routine iron supplements will not necessarily benefit your health and may cause you unpleasant side effects such as heartburn, constipation or diarrhoea. Your midwife will check your blood at your booking appointment and at 28 weeks of pregnancy. You will only be advised to take iron if you are found to be anaemic or are at increased risk of becoming anaemic in pregnancy, for example if you are carrying twins. Can I get help to buy vitamins? If you are on certain benefits and/or are under the age of 18 years, help may be available to provide you with free supplements. You can buy folic acid or pregnancy multivitamins from any pharmacy or supermarket. There is no evidence that expensive brands are any better than cheaper ones. Where can I find out more information about healthy eating? The following website can give you information about healthy eating before and during pregnancy and while breastfeeding: NHS Choices Your Pregnancy and Baby Guide: Making a choice Sources and acknowledgements This information has been developed by the RCOG Patient Information Committee. It is based on information from the NHS Choices website above and the RCOG scientific impact paper Nutrition in Pregnancy (September 2010; available at: which contains a full list of the sources of evidence we have used. 5

6 The RCOG produces guidelines as an educational aid to good clinical practice. They present recognised methods and techniques of clinical practice, based on published evidence, for consideration by obstetricians and gynaecologists and other relevant health professionals. This means that RCOG guidelines are unlike protocols or guidelines issued by employers, as they are not intended to be prescriptive directions defining a single course of management. This information has been reviewed before publication by women attending clinics in London, Sheffield and Kirkcaldy. A glossary of all medical terms is available on the RCOG website at: A final note The Royal College of Obstetricians and Gynaecologists produces patient information for the public. The ultimate judgement regarding a particular clinical procedure or treatment plan must be made by the doctor or other attendant in the light of the clinical data presented and the diagnostic and treatment options available. Departure from the local prescriptive protocols or guidelines should be fully documented in the patient s case notes at the time the relevant decision is taken. All RCOG guidelines are subject to review and both minor and major amendments on an ongoing basis. Please always visit for the most up-to-date version of this guideline. Royal College of Obstetricians and Gynaecologists

Information for you Published in November 2011 (next review date: 2015) Why your weight matters during pregnancy and after birth Most women who are overweight have a straightforward pregnancy and birth

Trying for a Baby Deciding to have a baby is a really exciting time and you will be thinking about many aspects of your life. You may take a look at your lifestyle and think about making some changes to

Healthy Eating During Pregnancy Pregnancy is a time of great change. Your body is changing to allow your baby to grow and develop. Good nutrition will help you meet the extra demands of pregnancy while

Healthy Eating for Pregnancy The Health Promotion Unit of the Department of Health and Children acknowledges and thanks the Paediatric Interest Group of the Irish Nutrition and Dietetic Institute for their

Iron in your diet Iron in your diet Why is iron important? Iron is important because it helps your body to make haemoglobin. Haemoglobin, or Hb, is the protein found in red blood cells that carries oxygen

If you need this, or any other NHS Grampian publication in an alternative format (large print, audio tape etc) or in another language please contact Corporate Communications. (t)01224 554400 (e) grampian@nhs.net

Introduction Eating well when pregnant is one of the first and best gifts you can give to your baby. What you choose to eat will influence your health and his. You might be unsure about what is right for

Vitamin supplements and you For pregnant or breastfeeding women, and babies and young children About this leaflet Vitamins are really important they are essential nutrients that your body needs, in small

Name: Date: 1. One Purpose of the Dietary Guidelines for Americans (DGAs) is to a) Provide a science base for U.S. food and nutrition program policies - See page 6 b) Encourage everyone to eat a balanced

gestational diabetes my pregnancy, my baby, and me What is Gestational Diabetes? Gestational diabetes occurs when your body cannot make adequate use of sugar in the blood. It is first found during pregnancy.

High-iron diet What is iron? Iron is a mineral found in every cell of the human body. Iron helps to carry oxygen from our lungs, around our bodies, to our brain and our muscles. This helps to keep us physically

DIABETES & HEALTHY EATING Food gives you the energy you need for healthy living. Your body changes most of the food you eat into a sugar called glucose. (glucose) Insulin helps your cells get the sugar

WOMEN AND NEWBORN HEALTH SERVICE King Edward Memorial Hospital Good Foods for Young Mums-to-be PREGNANCY Delivering a Healthy WA It is important to eat well when you are pregnant so that you and your baby

Iron in your diet Patient information Iron in your diet Why is iron important? Iron is important because it helps your body to make haemoglobin. Haemoglobin, or Hb, is the protein found in red blood cells

Vitamin supplements and you Guidance for pregnant or breastfeeding women, babies and young children Health Improvement About this leaflet Vitamins are really important they are essential nutrients that

Teachers Notes The eatwell plate The eatwell plate is a pictorial food guide showing the proportion and types of foods that are needed to make up a healthy, varied and balanced diet. The plate has been

Iron in your diet Patient information Iron in your diet Why is iron important? Iron is important because it helps your body to make haemoglobin. Haemoglobin, or Hb, is the protein found in red blood cells

The Eatwell Plate healthyfutures.nhs.uk/llb A balanced diet is important for good health. It can help you to manage your weight and increase your wellbeing, whilst also reducing the risk of heart disease,

Ideas for improving your calcium intake This booklet is designed to help you increase dietary calcium intake using foods high in calcium to maintain healthy bones and teeth This booklet was given to you

01 Balanced diet The Eatwell Plate What is a balanced diet? Your balanced diet will be specific to you it will depend on your age, your body weight and your gender. It also depends on how active you are.

Dietary Recommendations for Healthy Children Older Than 2 Years of Age 1. Nutritionally adequate diet consisting of a variety of foods. Increase dietary fiber by eating more whole grains, legumes, fruits

Healthy Eating: A Whole Diet Approach. The importance of a healthy and varied diet A good diet is important for good health. A healthy and varied diet can help to maintain a healthy body weight, enhance

Pregnancy Planning Your health and habits affect a baby from the earliest days of a pregnancy. Before you find out for sure that you are pregnant, a great deal has already happened. Your baby's major organs

Good Nutrition in pregnancy A healthy pregnancy is important for you and your baby www.health.act.gov.au WOMEN, YOUTH & CHILDREN COMMUNITY HEALTH PROGRAMS Good Nutrition in pregnancy 1 Good Nutrition in

Every Baby Matters Guidelines for good Nutrition in Bradford and Airedale Preparing for a healthy pregnancy (preconception) INTRODUCTION Good nutritional status before conception is important for the future

English Advice about food for you who are pregnant During pregnancy many women start to think about their eating habits. Perhaps you do, too. Previously you have only needed to think about yourself. Now

Nutrition and Exercise During Pregnancy Introduction Healthy eating and exercising are important for a healthy pregnancy. This reference summary will give you tips on eating and exercising during pregnancy.

8 TIPS FOR EATING WELL These practical tips can help you make healthier choices. The two keys to a healthy diet are eating the right amount of food for how active you are and eating a range of foods to

Healthy Eating for Diabetes What is diabetes and why is it important to manage it? Diabetes occurs when there is too much glucose in the blood. Learning how to manage your diabetes will help you feel better

CHILD CARE DIPLOMA Course Sample Unit CHP2 Providing for children s physical needs inclusive of health and safety The Statutory framework for the EYFS is a requirement for all registered early years providers.

Nutrition During Pregnancy A balanced diet is a basic part of good health at all times in your life. During pregnancy, your diet is even more important. The foods you eat are the main source of nutrients

University College Hospital How to get enough iron in your child s diet Information for parents and guardians Department of Nutrition & Dietetics (Paediatrics) If you would like this document in another

Eating for Two healthy eating for pregnancy The best food and how much to eat. Nutrition during pregnancy C ontrary to popular belief, eating for two is not an excuse to fill up on just any food that takes

Dietary advice for people starting treatment for Hepatitis C Information for patients Sheffield Dietetics Do I need to follow a special diet? You don t need to have a special diet but you should try and

This questionnaire is designed to allow you to assess the nutritional value of your diet. Answer yes or no to the questions below and then read the supplementary information that will help you to consider

Providence Maternal Care Clinic: Nutrition, Exercise and Emotional Health Nutrition and Weight Gain You do not have to eat a lot more food during pregnancy. But it is important to eat the healthiest food

What to do when you have Type 2 diabetes An easy read guide What is diabetes?? Sometimes your body does not make enough insulin. Sometimes your body can t use insulin properly. Insulin helps you to use

HIV/AIDS AND NUTRITION agriculture Department: Agriculture REPUBLIC OF SOUTH AFRICA HIV/AIDS AND NUTRITION Eating correctly does make a difference! When your body gets enough of the right food, you will

Dietary advice for patients taking Orlistat (Xenical) Information for patients Sheffield Dietetics Introduction Being overweight is associated with a variety of medical problems and diseases, for example

The Dietary Advice to Stop Hypertension eating plan 1 The Dietary Advice to Stop Hypertension (DASH) eating plan, developed by United States National Institute of Health, features plenty of fruits, vegetables,

Living and Eating Well Eating Well on Anti-Retrovirals (ARVs) for Adults This booklet will give you important information about how to eat better and manage your health through nutrition when you are on

Calcium and Vitamin D: Important at Every Age National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892-3676 Tel: (800) 624-BONE or

Calcium Introduction Calcium is a mineral found in many foods. The body needs calcium to maintain strong bones and to carry out many important functions. Not having enough calcium can cause many health

Healthy Eating You are what you eat! So before you even shop for food, it is important to become a well informed, smart food consumer and have a basic understanding of what a heart healthy diet looks like.

Polycystic ovary syndrome: what it means for your long-term health Information for you Published in February 2005, minor amendments in June 2005 Revised 2009 What is polycystic ovary syndrome? Polycystic

CHAPTER 4 Nutrition 51 Learning About Nutrition Nutrition Nutrition is how the body uses food to stay healthy. Good nutrition means that the body gets enough of the foods it needs to stay healthy. Poor

SS-207-06 For more information, visit the Ohio Department of Aging web site at: http://www.goldenbuckeye.com and Ohio State University Extension s Aging in Ohio web site at: http://www.hec.ohio-state.edu/famlife/aging

Youth Soccer Players Nutrition Schedule Pride in the Program This is a guide used to assist in the healthy nutrition of a youth soccer player Table of Contents Typical Training Day Schedule..3 Tournament

Nutrition Information from My Plate Guidelines Note: This information was compiled from the website: http://www.choosemyplate.gov/ for participants in the 4-H Food Prep Contest 1/12/16. The information

Nutrition for Twins plus When you are pregnant with twins or triplets, nutrition and weight gain are very important factors for a healthy pregnancy outcome. You also have greater needs and are at higher

Insulin Dependent Diabetes Trust Type 2 and You April 2010 Registered Company Number 3148360 Registered Charity No 1058284 Welcome to the third issue of Type 2 and You. In this issue we look at healthy

Red Meat & Nutrients The role of red meat in a balanced diet InsIde Great Tasty Recipe EatWelshLamb.com EatWelshBeef.com MeatandHealth.com Get the facts Other meaty facts booklets in the series; red meat

Diet, activity and your risk of prostate cancer Prostate cancer is the most common cancer in men in the UK. About one in eight men (12.5 per cent) will get prostate cancer at some point in their lives.

Iron Deficiency Anaemia Iron deficiency anaemia is a common type of anaemia that develops due to insufficient iron. Iron is necessary to make haemoglobin, a substance in red blood cells that enables them

Cholesterol and your health Understanding cholesterol What is cholesterol? Cholesterol is a waxy, fatlike substance found in the blood and in all the cells of your body. Your body makes all the cholesterol

Every Baby Matters Guidelines for good nutrition in Bradford and Airedale Nutrition and pregnancy INTRODUCTION Pregnancy needs and uses a large amount of energy and nutrients. Foetal development is sensitive

LEARNING OBJECTIVES By the end of the lesson, you will be able to: discuss some of the reasons why people eat what they eat; Making good understand the reasons behind your own personal food choices; LESSON

Eat Smart! Follow the Healthy Eating Food Pyramid! Food contains various types of nutrients to keep us healthy. For the sake of health, the nutritional value, functions, freshness and hygiene condition

My Diabetic Meal Plan during Pregnancy When you have diabetes and are pregnant, you need to eat small meals and snacks throughout the day to help control your blood sugar. This also helps you get in enough

What Should I Eat to Help my Pressure Sore or Wound Heal? Information for Patients i Leicestershire Nutrition and Dietetic Service Tissue Viabililty Team University Hospitals of Leicester NHS Trust Introduction

Healthy eating for toddlers Toddlerhood is a time where children learn about new foods and where life long eating habits are often established. To help children grow up to be healthy adults, it is important

What dietary guidelines should persons with Alpha-1-Antitrypsin Deficiency observe? Living with Alpha-1-Antitrypsin Deficiency Patient Information Program About this booklet The right dietary habits play

page 1 Folic Acid Q: What is folic acid? A: Folic (FOH-lik) acid is a B vitamin. It helps the body make healthy new cells. Folic acid and folate mean the same thing. Folic acid is a manmade form of folate.

Patient Education The First 2 Weeks After Gastric Bypass Surgery What you may eat and tips to help you recover This handout offers guidelines to help you: Choose the right foods right after surgery and

MANAGING VITILIGO Nutrition A common question that people with vitiligo ask is whether their diet makes any difference to their skin condition. Choosing the food we eat is something we can manage, so having

A Quick Guide to the Government s Healthy Eating Recommendations About Public Health England Public Health England exists to protect and improve the nation's health and wellbeing, and reduce health inequalities.

Achieving a Balanced Diet It has long been recognised that a healthy balanced diet is an important contributor to our short and long-term health and can help to achieve a balance in both our body and mind.

Page 1 of 5 High Blood Pressure (Hypertension) If you have high blood pressure, you have an increased risk of developing heart disease, a stroke, and other serious conditions. In some cases blood pressure

Let s talk about DIET, WEIGHT & EXERCISE Over a period of 18 months, I lost 4 Stone The difference it has made to her confidence and willingness to look for clothes is a joy (Fiona s mother) A workbook

Nutrition during Pregnancy Eating well before and during pregnancy helps to ensure that your baby has a healthy start. There is no magical formula for pregnancy nutrition, in fact, during pregnancy the

Catering for vegetarians and vegans Amanda Woodvine amanda@vegetarianforlife.org.uk A UK charity dedicated to improving the quality of life for older vegetarians and vegans. Survey In October 2014, VfL

Vitamin D Why Vitamin D is important and how to get enough Why is vitamin D vital for health? Vitamin D is needed by the body for both physical and mental health, but is best known for making sure bones

Food is made up of different building blocks. Fat, protein and carbohydrate are the main nutrients that give you energy but they also have other roles. While fibre doesn t provide much energy, it has other

Teaching Manual for the Dietary Guideline Placemats 1 Lesson #1: The Placemat Description: This lesson will provide an overview of the purpose and message behind the placemats. Things to bring to the lesson: